1.1 	A bill for an act
1.2 	relating to health; authorizing a computer-based model to assess the impact of 
1.3 	health care reform proposals; requiring a study of changes to state budgeting 
1.4 	approaches; appropriating money.
1.5 	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

1.6 	Section 1. GLOBAL MODELING OF HEALTH CARE REFORMS.
 1.7 		Subdivision 1.Reform modeling tool. To the extent of available appropriations, 
1.8 	the commissioner of health shall award a grant to the University of Minnesota School 
1.9 	of Public Health, health policy and management division, to develop a model that will 
1.10 	assess the impact of proposed health care reforms or major health care-related legislation 
1.11 	on all sectors of the health care system, including access to the full range of health care, 
1.12 	public health, public and private health insurance coverage, long-term and continuing 
1.13 	care, programs for persons with disabilities, social services and other sectors related to 
1.14 	Minnesotans' health. The model must be:
1.15 	(1) developed with safeguards to make sure that the model and its assumptions and 
1.16 	formulas are based on valid and objective data, research, and expert opinions;
1.17 	(2) designed to enable policy makers and state agencies to enter into the model and 
1.18 	study each component of health care reform, including access to all aspects of health care 
1.19 	services, health care homes, payment reforms, population-wide prevention, health status 
1.20 	of Minnesotans, and incidence of chronic disease;
1.21 	(3)  capable of assessing the interaction of different legislative and policy changes 
1.22 	to determine the net effect on costs, access, and health status within sectors of the health 
1.23 	care system, and the net overall impact across all sectors;
2.1 	(4) designed to identify risks of unpredictable or unintended consequences, cost 
2.2 	shifting between or within sectors of the health care system, and opportunities to make 
2.3 	changes in one sector that will produce a benefit to other sectors; and
2.4 	(5) capable of being adjusted based on both the proposed changes and the resulting 
2.5 	impact in the following areas:
2.6 	(i) access to all aspects of health care services;
2.7 	(ii) health status of Minnesotans, including the incidence of chronic disease, health 
2.8 	disparities, and risk factors such as obesity and smoking;
2.9 	(iii) utilization of preventive care services such as screenings, immunizations, and 
2.10 	physical examinations; and
2.11 	(iv) costs and cost distribution, including costs to individuals and families, 
2.12 	businesses, and government, including for total cost of health care, health-related services, 
2.13 	and social services.
2.14 		Subd. 2.Fiscal notes on health care reform legislation. (a) The University of 
2.15 	Minnesota model shall be available to state agencies and the legislature to:
2.16 	(1) conduct a global impact assessment of major health policy changes proposed 
2.17 	in legislation;
2.18 	(2) measure the impact of the proposed legislation on health and well-being; and
2.19 	(3) quantify the costs and savings in every part of the state's budget, in local 
2.20 	government budgets, and for individuals and businesses.
2.21 	(b) The commissioners of human services, finance, and health, in consultation with 
2.22 	the chairs of the senate and house health care policy and finance committees, shall develop 
2.23 	recommendations for the governor and the legislature on changes to state budgeting 
2.24 	approaches and legislative processes that will bridge across traditional budget boundaries 
2.25 	in order to both assess the impact of proposed legislative changes across these boundaries 
2.26 	and to allow the reallocation of resources across boundaries. These approaches shall also 
2.27 	cover a time period longer than the existing two-year budgeting cycle so that longer 
2.28 	term return-on-investment projections can be considered when making short-term budget 
2.29 	decisions.

2.30 	Sec. 2. ECONOMIC ANALYSIS OF HEALTH CARE REFORM PLANS.
 2.31 	(a) To the extent of available appropriations, the commissioner of health shall 
2.32 	award a grant to the University of Minnesota School of Public Health, health policy and 
2.33 	management division, to conduct a study and economic analysis of costs and benefits 
2.34 	of various health care reform proposals, including an analysis of the recommendations 
3.1 	of the Legislative Health Care Access Commission, the governor's transformation task 
3.2 	force, and a single statewide plan.
3.3 	(b) The analysis of each proposal should measure the impact on total public and 
3.4 	private health care spending in Minnesota that would result from each proposal, including 
3.5 	whether there are savings or additional costs due to:
3.6 	(1) increased or reduced insurance, billing, underwriting, marketing, and other 
3.7 	administrative functions;
3.8 	(2) timely and appropriate use of medical care;
3.9 	(3) market-driven or negotiated prices on medical services and products, including 
3.10 	pharmaceuticals;
3.11 	(4) a shortage or excess capacity of medical facilities and equipment;
3.12 	(5) increased utilization, better health outcomes, increased wellness due to 
3.13 	prevention, early intervention, and health-promoting activities;
3.14 	(6) increases or decreases in administrative expenses and health care expenses 
3.15 	due to payment reforms;
3.16 	(7) increases or decreases in administrative expenses and health care expenses due 
3.17 	to coordination of care;
3.18 	(8) increases or decreases in up-front and long-term utilization due to access to 
3.19 	comprehensive medically necessary benefits, including dental care, mental health care, 
3.20 	prescription drugs, and other health care; and
3.21 	(9) nonhealth care impacts on state and local expenditures such as reduced 
3.22 	out-of-home placement or crime costs due to mental health or chemical dependency 
3.23 	coverage.
3.24 	(c) The study should also analyze for each proposal the number of Minnesotans 
3.25 	without access to health care, including those lacking access to certain types of medical 
3.26 	care, such as dental care, mental health care, and prescription drugs.

3.27 	Sec. 3. EFFECTIVE DATE.
 3.28 	Sections 1 and 2 are effective the day following final enactment.